Objective:
To assess associations between lifetime sexual assault and childlessness in female veterans.

Design:
Cross-sectional, computer-assisted telephone interview study.

Setting:
Two Midwestern Veterans Administration (VA) medical centers.

Patient(s):
A total of 1,004 women aged ≤52 years, VA-enrolled between 2000 and 2008.

Intervention(s):
None.

Main Outcome Measure(s):
Sociodemographic variables, reproductive history and care utilization, and mental health.

Result(s):
A total of 620 veterans (62%) reported at least one attempted or completed sexual assault in their lifetime (LSA). Veterans with LSA more often self-reported a history of pregnancy termination (31% vs. 19%) and infertility (23% vs. 12%), as well as sexually transmitted infection (42% vs. 27%), posttraumatic stress disorder (32% vs. 10%), and postpartum dysphoria (62% vs. 44%). Lifetime sexual assault was independently associated with termination and infertility in multivariate models; sexually transmitted infection, posttraumatic stress disorder, and postpartum dysphoria were not. The LSA by period of life was as follows: 41% of participants in childhood, 15% in adulthood before the military, 33% in military, and 13% after the military (not mutually exclusive). Among the 511 who experienced a completed LSA, 23% self-reported delaying or foregoing pregnancy because of their assault.

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